London Hazards Centre subscription form

Membership | Home page

Subscription Form
Complete this form if you want to take out a subscription to the London Hazards Centre. Either fill it in, then print it out and return it to us with a cheque, or submit it from this web page, in which case we will issue an invoice.

*Sector*
	Unwaged individuals	£5
	Waged individuals	£15
	Public sector	£25
	Private sector	£110

Organisation, authority, business (if appropriate)

Name

Daytime telephone

Email

Address

A. Either

I have printed this form and enclose a cheque for payment

I enclose a cheque for
All payments must be in sterling. Make cheques payable to 'London Hazards Centre'.
Please return this form to London Hazards Centre, 213 Haverstock Hill, London NW3 4QP.

B. Or

I am submitting this form via the web, please send me an invoice

Invoice address (check this box if invoice address is same as postal address)

Top of page